Tooth Abscess

(Dental Abscess; Abscessed Tooth)

Definition

A tooth abscess is a sac of infected material called pus in a tooth or the gums.
Abscess Between Tooth and Gum
Abscess tooth
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Causes

A tooth abscess is caused by bacteria. It begins when bacteria invade and infect a tooth. This results in pus build-up. When the pus is unable to drain, an abscess results.Conditions that allow bacteria to invade a tooth include:
  • Severe tooth decay
  • Break or crack in a tooth that lets bacteria invade the pulp
  • Failed root canal treatment

Risk Factors

Factors that may increase your chance of a tooth abscess include:
  • Build up of tartar or calculus beneath the gum line
  • Poor dental hygiene leading to cavities and periodontal diseases

Symptoms

A tooth abscess may cause:
  • Throbbing/lingering pain in a tooth or gum area
  • Pain when biting
  • Pain from hot or cold
  • Sudden tooth pain
  • Redness, tenderness, or swelling of the gums
  • Fever
  • Bad breath or foul taste in mouth
  • Open, draining sore on the gums
If left untreated, complications of tooth abscess include:
  • Loss of tooth and surrounding tissues or bone
  • Spread of infection to surrounding tissue or bone

Diagnosis

Your dentist will ask about your symptoms and medical history. A detailed exam of your teeth and gums will be done. Images may need to be taken of the tooth and surrounding bone. This can be done with x-ray. A sample of the abscess fluid may be taken and tested.

Treatment

Removal of Abscess Via Root Canal

  • If an abscess results from tooth decay or a break or crack in the tooth:
    • The tooth and surrounding tissue is numbed and a hole is drilled through the top of the tooth.
    • Pus and dead tissue are removed from the center of the tooth.
    • The interior of the tooth and the root canals are cleaned and filled with a permanent filling.
    • A crown is placed on the tooth to protect it.
  • If an abscess results from infection between the tooth and gum:
    • The abscess is drained and thoroughly cleaned.
    • The root surface of tooth is cleaned and smoothed.
    • In some cases, surgery to reshape the gum is done to prevent a repeat infection.

Tooth Extraction (Removal)

  • Tooth extraction may be required if:
    • Tooth decay and/or tooth infection is too extensive for filling or root canal treatment.
    • The break or crack in the tooth is too severe to be repaired.
    • The infection or loss of tissue/bone between the tooth and gum is severe.
  • If the tooth is extracted, it will be replaced with a:
    • Partial bridge
    • Denture
    • Tooth implant

Medication

  • Antibiotics to fight residual infection of the tooth or gums
  • Over-the-counter pain relief drugs such as ibuprofen or acetaminophen

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Prevention

To help reduce your chance a tooth abscess:
  • Brush your teeth with fluoride toothpaste after meals or at least twice per day.
  • Floss between your teeth and gums every day.
  • Get regular dental check-ups and teeth and gum cleanings every 6 months.

RESOURCES

Academy of General Dentistry
http://www.agd.org

Mouth Healthy—American Dental Association
http://www.mouthhealthy.org

CANADIAN RESOURCES

Canadian Dental Association
http://www.cda-adc.ca

The Canadian Dental Hygienists Association
http://www.cdha.ca

References

Abscess (toothache). American Dental Association Mouth Healthy website. Available at: http://www.mouthhealthy.org/en/az-topics/a/abscess. Accessed March 18, 2013.

Beers MH, Fletcher AJ. The Merck Manual of Medical Information—Home Edition . New York, NY: Simon and Schuster, Inc.; 2000.

Dental abscess. NHSinform website. Available at: http://www.nhsinform.com/health-library/articles/d/dental-abscess/introduction. Updated October 4, 2011. Accessed March 18, 2013.

Root canals. American Dental Association Mouth Healthy website. Available at: http://www.mouthhealthy.org/en/az-topics/r/root-canals. Accessed March 18, 2013.

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